What Happens If You Don’t Have Health Insurance and You Go to the Hospital? Emergency Hospital Visits Without Insurance

If you go to the hospital in an emergency and do not have insurance, the hospital staff legally has to treat you. However, you may be turned away if you’re not facing a medical emergency. Life-threatening emergencies or active labor require a hospital to stabilize or transfer you — even if you do not have insurance. If you do not pay your final bill, the hospital may send your bill to a collection agency.

Costs of Medical Care

The average overnight hospital stay costs about $11,700. This price tag varies significantly by type of insurance coverage (and if you have insurance coverage at all). Emergency medical care, and the complexities involved in diagnosing and treating medical issues, is expensive. It costs a lot of money to keep an emergency room open and running at all times with a highly trained, often specialized, paid staff.

Medical debt is any balance owed after receiving medical services, says Shannon P. Miller, a partner at financial services law firm Maurice Wutscher. "In a broad sense, this would include amounts owed that are not past due, as well as amounts that are delinquent," Miller says. Medical debt is the most common collection reported on credit records. If it adds up, you could deal with a damaged credit score, bankruptcy, or financial problems.

Managing Without Insurance

If you find yourself at the hospital without insurance, let them know up-front, as sometimes hospitals will offer discounts for the uninsured. You can also speak to the hospital ombudsman about "charity care," or financial assistance programs that allow you to pay off your debt. Non-profit hospitals must offer these plans to low-income patients.

Urgent care often costs roughly half as much as the ER. However, at an urgent care center, you may have to pay in advance without insurance.

There are financial risks associated with lacking health insurance. Medical expenses can quickly rack up into thousands of dollars. Without insurance, medical bills will seem astronomical and could wipe out savings or put you into debt. You would be responsible for paying treatment costs fully out of pocket. To avoid such risks, health insurance coverage is essential.

The Cost of Uninsurance

Going to the hospital without insurance can be costly, but unfortunately, it’s a reality for millions of Americans. The federal Emergency Medical Treatment and Labor Act (EMTALA) guarantees a person’s right to receive emergency treatment, regardless of whether they can pay. However, once your condition is stable, you may be required to leave or be admitted and billed. This can include hospitalization, tests, procedures, medications, and services. If you are unable to pay, you may be contacted by billing or collections.

Hospitals accepting federal money must provide free or reduced care. Check the hospital’s financial aid office if you qualify. There are still options to find affordable care without insurance. But avoiding needed medical care due to costs could negatively impact health and expenses down the road. Seeing a doctor promptly is vital.

Why would someone lack health insurance? There are many reasons people don’t have coverage, including rising costs and financial hardship. The uninsured are typically working adults between 19 to 44. Hispanics are more likely than other races to lack coverage.

Having health insurance is an important part of managing your overall health, as well as protecting yourself financially. However, many people are uninsured or underinsured. Being uninsured is a gamble. If anything unexpected happens medically, you risk losing a significant amount financially.

The open enrollment period for marketplace health insurance plans is when most people can sign up, typically in the fall for coverage starting in January. If you miss open enrollment, you’ll have to wait another year to sign up unless you have a special life event allowing special enrollment, like losing a job, having a child, or getting married.

California requires individuals to have health insurance or pay a tax penalty. In 2021, the annual penalty is 2.5% of household income or at least $750 per adult and $375 per child, whichever is greater. Without coverage, a serious accident or health issue requiring emergency care and expensive treatment can result in bankruptcy.

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